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In Case You Missed It:

A prescription for better health: go alfresco

Spending time outside might have some health benefits — and
the 'greening' of exercise might have some more.

Summer is the time when the outdoors beckons. We go to the beach
in droves, have picnics and barbecues, paddle and fish and swim.
Some hike, others bike, and a few do both — although not at the
same time.

But these good times in the out of doors are really an exception
to the rule, which is that most of us spend the vast majority of
our time inside. According to one government estimate, the
average American spends 90% of his or her life indoors, and as we
get older we become even more inclined not to venture out.

When we do, there's a gantlet of precautions: slather on the
sunscreen; take it easy — or head indoors — if air quality is
bad; watch out for ticks, mosquitoes, and other creatures that
might bite. It's all very well-meaning but it also reinforces
indoor ways.

So it's back into the bunker — but that might not be good for
you. The study results are ticking up: spending time outdoors
seems to have discernible benefits for physical and mental
health. Granted, some are merely by association and can be
achieved by other means, perhaps while indoors, but often only
with a good deal more trouble and expense. Here are five
potential benefits of spending more time outdoors:

1. Your vitamin D levels will go up

Vitamin D is called the sunshine vitamin because sunlight hitting
the skin begins the circuitous process — the liver and kidneys
get involved — that eventually leads to the creation of the
biologically active form of the vitamin. Over all, research is
showing that many vitamins, while necessary, don't have such
great disease-fighting powers, but vitamin D may prove to be the
exception. Epidemiologic studies are suggesting it may have
protective effects against everything from osteoporosis to cancer
to depression to heart attacks and stroke. Even by conventional
standards, many Americans don't have enough vitamin D circulating
in their bodies. The good news is that you'll make all the
vitamin D you need if you get outside a few times a week during
these summer days and expose your arms and legs for 10 to 15
minutes. Of course, it has to be sunny out.

There are some snags. Vitamin D production is affected by age
(people ages 65 and over generate about a fourth as much as
people in their 20s) and skin color (African Americans have, on
average, about half the levels of vitamin D in their blood as
white Americans).

Another problem: sunscreens are most effective at blocking the
ultraviolet B (UVB) light, the part of the spectrum that causes
sunburn, but UVB also happens to be the kind of light that
kick-starts the generation of vitamin D in the skin.

The either-or of sunscreen and sunshine vitamin has stirred up a
lot of controversy and debate between pro-sunscreen
dermatologists and the vitamin D camp. But there is plenty of
middle ground here: some limited sun exposure on short walks and
the like, supplemented with vitamin D pills if necessary, and
liberal use of sunscreen when you are out for extended periods,
particularly during the middle of the day.

2. You'll get more exercise (especially if you're a child)

You don't need to be outside to be active: millions of people
exercise indoors in gyms or at home on treadmills and elliptical
trainers. Nor is being outside a guarantee of activity. At the
beach on a summer day most people are in various angles of
repose.

Still, there's no question that indoor living is associated with
being sedentary, particularly for children, while being outdoors
is associated with activity. According to some surveys, American
children spend an average of 6 hours a day with electronic media
(video games, television, and so on), time that is spent mainly
indoors and sitting down. British researchers used Global
Positioning System devices and accelerometers, which sense
movement, to track the activity of 1,000 children. They found
that the children were more than doubly active when they were
outside.

Adults can go to the gym. Many prefer the controlled environment
there. But if you make getting outside a goal, that should mean
less time in front of the television and computer and more time
walking, biking, gardening, cleaning up the yard, and doing other
things that put the body in motion.

3. You'll be happier (especially if your exercise is 'green')

Light tends to elevate people's mood, and unless you live in a
glass house or are using a light box to treat seasonal affective
disorder, there's usually more light available outside than in.
Physical activity has been shown to relax and cheer people up, so
if being outside replaces inactive pursuits with active ones, it
might also mean more smiles and laughter.

Researchers at the University of Essex in England are advancing
the notion that exercising in the presence of nature has added
benefit, particularly for mental health. Their investigations
into "green exercise," as they are calling it, dovetails with
research showing benefits from living in proximity to green, open
spaces.

In 2010 the English scientists reported results from a
meta-analysis of their own studies that showed just five minutes
of green exercise resulted in improvements in self-esteem and
mood.

Mind you, none of the studies were randomized controlled trials.
The intuitive appeal of green exercise is its strength, not the
methodological rigor of the research supporting it. It's hard to
imagine how a stroll in a pretty park wouldn't make us feel
better than a walk in a drab setting.

4. Your concentration will improve

Richard Louv coined the term "nature-deficit disorder" in his
2008 book Last Child in the Woods. It's a play on
attention deficit hyperactivity disorder (ADHD). Researchers
have, in fact, reported that children with ADHD seem to focus
better after being outdoors. A study published in 2008 found that
children with ADHD scored higher on a test of concentration after
a walk through a park than after a walk through a residential
neighborhood or downtown area. Other ADHD studies have also
suggested that outdoor exercise could have positive effects on
the condition. Truth be told, this research has been done in
children, so it's a stretch to say it applies to adults, even
those who have an ADHD diagnosis. But if you have trouble
concentrating — as many do — you might see if some outdoor
activity, the greener the better, helps.

5. You may heal faster

University of Pittsburgh researchers reported in 2005 that spinal
surgery patients experienced less pain and stress and took fewer
pain medications during their recoveries if they were exposed to
natural light. An older study showed that the view out the window
(trees vs. a brick wall) had an effect on patient recovery. Of
course, windows and views are different than actually being
outside, but we're betting that adding a little fresh air to the
equation couldn't hurt and might help.